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bortezomib (Velcade)

Tradename: Velcade (FDA approved 2003) Indications: - multiple myeloma - refractory multiple myeloma (28% of patients improve for 1 year) [1,2] - *in combination with dexamethasone +/- thalidomide for induction prior to high-dose chemotherapy with hematopoietic stem cell transplantation [NGC,NICE] - treatment of amyloidosis in combination with cycloposphamide & dexamethasone [3] - mantle cell lymphoma [5] Dosage: injectable agent Adverse effects: - neutrophilic dermatosis - pyoderma gangrenosum, Sweet syndrome [6] - reactivation of Herpes zoster - prophylactic acyclovir or valacyclovir indicated regardless of Herpes zoster immunization status [6] - peripheral neuropathy [6] Mechanism of action: 1) inhibits proteasomes involved in cell proliferation

General

antineoplastic enzyme inhibitor small inhibitory antineoplastic agent (ib drug)

Database Correlations

PUBCHEM correlations

References

  1. Prescriber's Letter 10(6):35 2003
  2. Richardson PG, Sonneveld P, Schuster MW, Irwin D, Stadtmauer EA, Facon T, Harousseau JL, Ben-Yehuda D, Lonial S, Goldschmidt H, Reece D, San-Miguel JF, Blade J, Boccadoro M, Cavenagh J, Dalton WS, Boral AL, Esseltine DL, Porter JB, Schenkein D, Anderson KC; Assessment of Proteasome Inhibition for Extending Remissions (APEX) Investigators. Bortezomib or high-dose dexamethasone for relapsed multiple myeloma. N Engl J Med. 2005 Jun 16;352(24):2487-98. PMID: 15958804
  3. Mikhael JR et al. Cyclophosphamide-bortezomib-dexamethasone (CyBorD) produces rapid and complete hematologic response in patients with AL amyloidosis. Blood 2012 May 10; 119:4391. PMID: 22331188 - Venner CP et al. Cyclophosphamide, bortezomib, and dexamethasone therapy in AL amyloidosis is associated with high clonal response rates and prolonged progression-free survival. Blood 2012 May 10; 119:4387. PMID: 22331187
  4. San Miguel JF, Schlag R, Khuageva NK et al Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med. 2008 Aug 28;359(9):906-17 PMID: 1875364
  5. Deprecated Reference
  6. Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19 American College of Physicians, Philadelphia 2015, 2018, 2022 - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022